The Association of Pipe and Cigar Use With Cotinine Levels, Lung Function, and Airflow Obstruction

A Cross-sectional Study

From Columbia University, New York, New York; University of Washington, Seattle, Washington; National Institute for Occupational Safety and Health, Cincinnati, Ohio; and Northwestern University, Chicago, Illinois.

Abstract

Background: Cigarette smoking is the major cause of chronic obstructive pulmonary disease, but studies on the contribution of other smoking techniques are sparse.

Participants: Men and women aged 48 to 90 years without clinical cardiovascular disease at enrollment who were part of MESA (Multi-Ethnic Study of Atherosclerosis).

Measurements: The MESA Lung Study measured spirometry according to American Thoracic Society guidelines and urine cotinine levels by immunoassay on a subsample of MESA. Pipe-years and cigar-years were calculated as years from self-reported age of starting to age of quitting (or to current age in current users) multiplied by pipe-bowls or cigars per day.

Conclusion: Pipe and cigar smoking increased urine cotinine levels and was associated with decreased lung function and increased odds of airflow obstruction, even in participants who had never smoked cigarettes.

Primary Funding Source: National Heart, Lung, and Blood Institute, National Institutes of Health.

Article and Author Information

Note: A full list of participating MESA investigators and institutions can be found at www.mesa-nhlbi.org.

Acknowledgment: The authors thank Firas Ahmed, MD, MPH, for substantial programming assistance, in addition to the other investigators, staff, and participants of the MESA and MESA Lung Study for their valuable contributions.

Grant Support: By the National Institutes of Health (R01-HL077612, N01-HC95159 to HC95169, R01-HL075476).

Reproducible Research Statement:Study protocol (for the MESA Lung Study) and statistical code: Available from Dr. Barr (e-mail, rgb9@columbia.edu). Data set: Available as a limited access data set from the NHLBI (www.mesa-nhlbi.org).